Calculating willingness-to-pay with discrete cost and random coefficients in discrete choice experiments.

Objectives: This study provides step-by-step guidance to calculate willingness-to-pay (WTP) in discrete choice experiments that involve discrete cost. It highlights the limitations of assuming a linear disutility for cost in WTP calculation.

Methods: Five mixed-logit models were considered.

Post-surgical morbidity in early versus late closure of defunctioning ileostomy after rectal cancer surgery: A systematic review and meta-analysis of randomised controlled trials.

Background: A defunctioning ileostomy is frequently created to avert the implications of a colo-rectal anastomotic dehiscence in rectal cancer surgery. The timing of closure of the ileostomy remains debatable as it is believed that early closure (EC) may be beneficial to most patients than the standard practice of late closure (LC). This meta-analysis was performed to compare surgical outcomes in patients who underwent EC versus LC.

Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021.

Importance: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

Objective: To estimate the worldwide burden of SAH.

Does adjuvant chemotherapy result in poorer health-related quality of life among colorectal cancer patients? A longitudinal multisite observational study in Singapore.

Background: Research on health-related quality of life (HRQOL) using minimally important differences for cancer care in Asian settings are sparse. This study aimed to describe functional HRQOL trajectories among Colorectal Cancer (CRC) patients undergoing adjuvant chemotherapy (AC) compared to those who did not (No AC), evaluate if AC was associated with change in HRQOL prospectively, and examine QOL differences between elderly and non-elderly CRC patients requiring AC.

Methods: CRC patients diagnosed between February 2018 to August 2021 were recruited from three Singapore public hospitals.

Is the ligation of the intersphincteric fistula tract (LIFT) procedure truly a sphincter preserving procedure for anal fistula? A scoping review of the literature.

Introduction: The ligation of the intersphincteric fistula tract (LIFT) procedure has garnered popularity with its success rates and purported sphincter-continence preservation. However, there remains a paucity in the literature on the objective evaluation of sphincter integrity and fecal continence after the LIFT procedure.

Objectives: The present study undertakes a scoping review to systematically explore and map the published literature, to evaluate the sufficiency of data on the impact on continence in patients after the LIFT procedure.

Risk factors for non-clinical prolonged lengths of stay after elective colorectal surgery.

Identification of reasons and causative factors for prolonged lengths of stay (LOS) after elective colorectal surgery in patients with uneventful postoperative recovery. A prospectively maintained database of colorectal cancer (CRC) patients between 2019 and 2021 was reviewed. Peri-operative parameters were evaluated to identify risk factors for prolonged LOS.

Health-Related Quality of Life After Colorectal Cancer Surgery in Older Patients Compared to the Young: A Prospective Multicentre Observational Study.

The impact of colorectal surgery on older adults' (≥65 years) health-related quality of life (HRQoL) is rarely reported. This prospective multi-institutional cohort study involving 217 participants investigated factors affecting older colorectal cancer (CRC) patients' HRQoL following surgery with the EORTC QLQ-C30 and the HADS. The trend of the global QoL and individual subscales show an overall dip in QoL from baseline to pre-discharge, before slowly rising until the 6-month mark.

Time to return of bowel function following perioperative probiotics in colorectal cancer surgery (PICCS-1): study protocol for a randomized controlled trial.

Background: Postoperative ileus occurs in up to 30% of patients following major oncologic surgery for colorectal cancer, leading to significant morbidity, patient distress, as well as increased utilization of healthcare resources. Various modalities to reduce postoperative ileus rates have been explored. One such modality is the perioperative administration of probiotics which have hitherto achieved inconsistent success.

Knowledge, attitudes and perceptions of advance care planning among specialist healthcare professionals in neurology, neuro-oncology and surgery.

Introduction: This study aimed to investigate the knowledge, attitudes and perceptions (KAP) of advance care planning (ACP) among specialist healthcare professionals (HCPs) in neurology, neuro-oncology and surgery.

Methods: This was a cross-sectional study of HCPs in Singapore. A standardised questionnaire was developed using validated questionnaires from the international literature, concepts of the Theory of Planned Behaviour and consultation with multidisciplinary palliative care specialists.

Trends in Early-Onset Colorectal Cancer in Singapore: Epidemiological Study of a Multiethnic Population.

Background: Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the past 2 decades. However, there is a rising incidence of CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). Patients with EOCRC are diagnosed at an advanced stage and may be in more psychosocial, emotional, and financial distress.

DUSP6 regulates Notch1 signalling in colorectal cancer.

Notch1 plays various roles in cancer development, and Notch1-induced transactivation is controlled by phosphorylation of its cleaved intracellular domain. However, it is unclear whether there are phosphatases capable of dephosphorylating the cleaved Notch1 transmembrane/intracellular region (NTM) to regulate its function. Here, we show that DUSP6 can function as a phosphatase for Notch1, thereby regulating NTM stability and transcriptional activity, thus influencing colorectal cancer (CRC) development.

Determinants of pneumococcal vaccination among older adults: A scoping review.

Objectives: To identify the range of factors that impact health behaviours pertaining to the uptake of pneumococcal vaccination (PV) among older persons.

Study Design: Scoping review.

Methods: This review followed Arksey and O'Malley's framework.

Increasing Colorectal Screening Uptake in Spouses of Patients With Colorectal Cancer Using a Randomized Behavioral Trial.

Background: Colorectal cancer (CRC) is one of the few cancers for which screening has been associated with better survival and morbidity, but screening uptake has been underexplored in spouses of existing patients with CRC. The objective of this study was to evaluate whether a brief, structured behavioral intervention delivered to spouses of patients with CRC in a colorectal clinical setting could increase fecal immunochemical test (FIT) uptake within 3 months of the study period.

Methods: This study was designed as a block randomized, unblinded, parallel trial conducted in the colorectal outpatient clinics of 2 public tertiary hospitals in Singapore from December 2017 to February 2023.

Advancing Colorectal Cancer Detection With Blood-Based Tests: Qualitative Study and Discrete Choice Experiment to Elicit Population Preferences.

Background: Colorectal cancer (CRC) is the second most deadly form of cancer, inducing an estimated 1.9 million incidence cases and 0.9 million deaths worldwide in 2020.

Quantifying chemotherapy-induced cognitive impairment in gastrointestinal cancer patients: A scoping review of methodological concerns in the literature.

Purpose: Chemotherapy is one of the common treatments in cancer management. However, chemotherapy-induced cognitive impairment (CICI) is one notable side effect that can greatly impact a patient's quality of life. Literature on CICI in gastrointestinal (GI) cancers are few and inconsistent.

Risk factors for lymph node metastasis in T2 colorectal cancer: a systematic review and meta-analysis.

Background: Lymph node metastasis (LNM) occurs in 20-25% of patients with T2 colorectal cancer (CRC). Identification of risk factors for LNM in T2 CRC may help identify patients who are at low risk and thereby potential candidates for endoscopic full-thickness resection. We examined risk factors for LNM in T2 CRC with the goal of establishing further criteria of the indications for endoscopic resection.

Use of patient-reported experience and outcome measures within the colorectal cancer care continuum: a scoping review.

Objective: Patient-reported outcome measures (PROM) are frequently adopted to evaluate colorectal cancer (CRC) care, but the use of patient-reported experience measures (PREM) appears to be underdeveloped and not widely validated. This scoping review aims to understand the contexts for deployment of PREMs in CRC care, reliability of measures, gaps in current use of PREMs, and how PREMs are associated with PROMs when deployed together.

Methods: Four scientific databases (PubMed, CINAHL, PsycINFO, Scopus) were systematically searched from January 2011 to December 2023.

Circular RNA as a source of neoantigens for cancer vaccines.

Background: The effectiveness of somatic neoantigen-based immunotherapy is often hindered by the limited number of mutations in tumors with low to moderate mutation burden. Focusing on microsatellite-stable colorectal cancer (CRC), this study investigates the potential of tumor-associated circular RNAs (circRNAs) as an alternative source of neoepitopes in CRC.

Methods: Tumor-associated circRNAs in CRC were identified using the MiOncoCirc database and ribo-depletion RNA sequencing of paired clinical normal and tumor samples.

A functional personalised oncology approach against metastatic colorectal cancer in matched patient derived organoids.

Globally, colorectal cancer (CRC) is the third most frequently occurring cancer. Progression on to an advanced metastatic malignancy (metCRC) is often indicative of poor prognosis, as the 5-year survival rates of patients decline rapidly. Despite the availability of many systemic therapies for the management of metCRC, the long-term efficacies of these regimens are often hindered by the emergence of treatment resistance due to intratumoral and intertumoral heterogeneity.

Differences in Attitudes and Barriers Towards Advance Care Planning Amongst Ischemic Heart Disease Patients: A Cross-Sectional Study.

Objectives: Perceptions towards advanced care planning (ACP) amongst individuals with Ischemic Heart Disease before or after a life-threatening Acute Myocardial Infarction event is underexamined and could impact the appropriate timing for ACP advocacy. This cross-sectional study assessed awareness and intentions regarding ACP in individuals with Ischemic Heart Disease, both before and after an Acute Myocardial Infarction, and explored the motivating effect of a near-fatal Acute Myocardial Infarction event on its engagement.

Methods: This study was conducted from 24 August 2021 through 13 March 2023, whereby patients were administered a one-time questionnaire with no follow-up required.

Alterations in colorectal cancer virome and its persistence after surgery.

Viruses are a key component of the colon microbiome, but the relationship between virome and colorectal cancer (CRC) remains poorly understood. We seek to identify alterations in the viral community that is characteristic of CRC and examine if they persist after surgery. Forty-nine fecal samples from 25 non-cancer (NC) individuals and 12 CRC patients, before and 6-months after surgery, were collected for metagenomic analysis.

Health-related quality of life thresholds of clinical importance at diagnosis can predict longitudinal post-operative health functioning in colorectal cancer patients: A prospective multicentre observational study.

Background: Health-related quality of life (HRQOL) is an increasingly important outcome in colorectal cancer (CRC) treatment. Established thresholds for clinical importance (TCI) permit an absolute interpretation of HRQOL scores but less emphasis has been placed on whether these can be used in a predictive manner. This study aimed to examine if patients' baseline HRQOL functioning scores, subgrouped based on TCI, would significantly predict HRQOL over time.

Challenges in Implementing Endoscopic Resection for T2 Colorectal Cancer.

The current standard treatment for muscularis propria-invasive (T2) colorectal cancer is surgical colectomy with lymph node dissection. With the advent of new endoscopic resection techniques, such as endoscopic full-thickness resection or endoscopic intermuscular dissection, T2 colorectal cancer, with metastasis to 20%-25% of the dissected lymph nodes, may be the next candidate for endoscopic resection following submucosal-invasive (T1) colorectal cancer. We present a novel endoscopic treatment strategy for T2 colorectal cancer and suggest further study to establish evidence on oncologic and endoscopic technical safety for its clinical implementation.